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目的分析18F-FDG PET/CT在检测非小细胞肺癌(NSCLC)区域淋巴结中出现假阴性和假阳性的因素。方法随机选择施行肺叶切除术的NSCLC患者58例,术前1周内行18F-FDG PET/CT检查,同期行CT增强扫描,术后根据病理检查结果分析PET/CT在诊断NSCLC区域淋巴结转移中的应用价值。结果 58例患者共切除淋巴结315枚,转移淋巴结52枚,PET/CT结果假阴性7枚,假阳性8枚,阳性和阴性预测值分别为87%,97%,高于CT(67%,90%;P=0.002,0.045)。结论假阴性是由于PET/CT稍逊的空间分辨率、低糖代谢率的淋巴结微转移灶、与原发灶毗邻的淋巴结误认为肿瘤。而合并肺部疾病所致淋巴结炎是PET/CT出现假阳性的主要原因。
Objective To analyze the 18F-FDG PET / CT in the detection of non-small cell lung cancer (NSCLC) regional lymph nodes appear false negative and false positive factors. Methods Fifty-eight patients with NSCLC undergoing lobectomy were randomly selected. One-week preoperative 18F-FDG PET / CT was performed and the contrast-enhanced CT scan was performed at the same time. The postoperative PET / CT was used to diagnose NSCLC regional lymph node metastasis Value. Results A total of 315 lymph nodes, 52 lymph node metastases, 7 false negatives and 8 false positives were found in 58 patients. The positive and negative predictive values were 87% and 97%, respectively, higher than those of CT (67% and 90% %; P = 0.002, 0.045). Conclusion False negative is due to PET / CT less spatial resolution, low glucose metabolism rate of lymph node micrometastasis, lymph node adjacent to the primary tumor mistaken for the tumor. Lymphadenitis associated with pulmonary disease is the main reason for the false positive of PET / CT.